Services & the Medicaid Web Portal application. Medicaid Information Technology Services (MITS) team develops and operates... Experience with Unix variants and Unix Scripting Experience with SQL Experience with MongoDB Medicaid Management...
a qualified Pharmacist to review Medicaid members’ Utilization Management requests, including formulary exceptions, prior... of this position. Responsibilities Review and evaluate Medicaid members’ Utilization Management requests. Apply clinical judgment...
+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience... provider agreements, including reimbursement provisions (e.g., percentage of Medicaid, percentage of Medicare, DRG, APC...
+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience... Resource-Based Relative Value System (RBRVS), and Medicaid fee schedules. Basic understanding of managed care contracting...
) PREFERRED QUALIFICATIONS Experience working with Medicaid clients and in behavioral health settings. Crisis intervention...
and dialysis with diagnosis coding. Follow up on unpaid invoices with Medicare and Medicaid. Medical records administration... with proficiency in data entry and keyboarding skills Knowledgeable in medical billing, to include Medicaid, Medicare, Private...
is helpful, but not required. Medicaid and/or Medicare familiarity Certificates in Licensed Clinical Social Worker(LCSW...
with applicable state and federal regulations, including the Centers for Medicare and Medicaid Services (CMS) regulations. Upon...
families, caregivers, DSPs. Participate in annual ISP meetings and team reviews. Complete Medicaid-compliant documentation...
systems. Familiarity with Medicare/Medicaid processes. Work Environment This is a 100% remote work environment...